The effect of pretreatment infarct growth rate (IGR) on the efficacy of endovascular thrombectomy (EVT) in patients with large core infarction is unclear. To evaluate the correlation between pretreatment of IGR and the efficacy of EVT in the treatment of large infarction, Professor Liping Liu's team from Beijing Tiantan Hospital affiliated to Capital Medical University conducted a study, and the results of the study were presented in abstract form at the European Stroke Organization Congress 2024 (ESOC 2024).
Overview of the study
In this study, a post-hoc analysis of EVT in the ANGELASPECT trial was performed. The primary endpoint was 90-day functional independence, defined as a modified Rankin scale (mRS) score of 0~2; IGR was calculated as the ratio of infarct core volume to time from stroke onset to imaging and was divided into three categories based on its relationship to functional independence.
A total of 455 patients with a mean age of 66 years (SD 9.8) were included, of whom 38.7% were women. Functional outcome interaction between IGR and EVT and medical management (Figs. 1,2). Patients were divided into slow progression group (IGR<5 mL/h, n=148), intermediate progression group (IGR 5-20 mL/h, n=221), and fast progression group (IGR>20 mL/h, n=86). As shown in Figure 3, there was a significant interaction between the IGR and treatment groups in terms of the odds of achieving functional independence (adjusted OR, 10.23 [95% CI, 3.7-28.29] vs. 3.07 [95% CI, 1.41-6.71] vs. 1.45 [95% CI, 0.45-4.71], interaction P = 0.03).
Figure 1. Effect of EVT on the functional independence of different IGRs
Figure 2. IGR locally weighted scatterplot smooth regression with functional results
Figure 3. 90d mRS score distribution in the IGR group
Conclusions of the study
Patients with slower-progressing large infarcts tend to benefit more from EVT, but patients with rapidly progressing do not. Combined with IGR assessment, it may be helpful to tailor EVT therapy to patients with large infarction.
医脉通编译自：INFARCT GROWTH RATE AND FUNCTIONAL INDEPENDENCE FOR LARGE INFARCT PATIENT WITH ENDOVASCULAR THROMBECTOMY. ESOC 2024.
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